Zielnik-Jurkiewicz Beata, Rakowska-Szkudlarek Magdalena
Oddział Otolaryngologiczny Szpitala Dzieciecego im. prof. dr med. Jana Bogdanowicza.
Otolaryngol Pol. 2009 Nov-Dec;63(6):513-9. doi: 10.1016/S0030-6657(09)70171-4.
The development of medicine, in this the new techniques and antibiotic therapy enlarged the survivability of patients in hospital. Applying antibiotics caused breakthrough in treatment stepping out in ill's group infections treated in hospital, however enlarging resistance is natural this effect, resulting from: the selection of resistant strains, the formation of new mechanisms of resistance, and/or the spreading of gene of resistance. Multidrug-resistant strains were included to emergence-pathogens group: MRSA, penicillin-resistant Streptococcus pneumoniae, VRE, Gram-negative producing beta-lactamase of type the ESBL and/or resistant to carbapenems. Emergence-pathogens occurrence leads to: therapeutic failures, the use extorts in therapy of dear medicines or with possibility of workings undesirable. The multidrug-resistant strains spread in hospital environment easily, especially on departments about high waste of medicines with the patients' simultaneously large susceptibility on infection, resulting mainly with state of reduced resistance of organism. The control of hospital infections recognize by present hospitality for the most important criterion of quality of work.
Analysis of the emergence-pathogens isolated during treatment in hospital in 2005-2008, from special regard the ENT Department.
50586 children treated in this period in hospital in which was executed 39386 bacteriological investigations, in this 6528 (12.9%) children in ENT Department in which was executed 1566 bacteriological investigations (3.98%). The diagnostics were executed according to routine microbiological procedures with qualification of resistance to antibiotics.
Emergence-pathogens infection was confirmed at 2369 children's (4.68%) treated in Hospital, in this in ENT Department at 84 children (1.29%). The most frequent emergence-pathogens in ENT Department were Streptococcus pyogenes, Streptococcus pneumoniae penicillin-resistant and average sensitive on penicillin, Staphylococcus aureus methicillin-resistant and Rotavirus.
Streptococcus pneumoniae penicillin-resistant and average sensitive to penicillin and Rotavirus infections are the most frequent hospital infections. The systematic microbiological supervision is indispensable in prevention the spreading of infections of the emergence-pathogens in hospital.
医学的发展,特别是新技术和抗生素疗法提高了患者在医院的生存率。应用抗生素在医院治疗的患者群体感染方面取得了突破,但耐药性增加是这种效果的自然结果,其原因包括:耐药菌株的选择、新耐药机制的形成和/或耐药基因的传播。多重耐药菌株被纳入新兴病原体组:耐甲氧西林金黄色葡萄球菌(MRSA)、耐青霉素肺炎链球菌、耐万古霉素肠球菌(VRE)、产超广谱β-内酰胺酶(ESBL)和/或耐碳青霉烯类的革兰阴性菌。新兴病原体的出现导致:治疗失败、使用昂贵药物进行治疗或出现不良作用的可能性。多重耐药菌株在医院环境中很容易传播,尤其是在药物浪费量大且患者同时对感染易感性高的科室,这主要是由于机体抵抗力下降所致。医院感染的控制被当前医院视为工作质量的最重要标准。
分析2005 - 2008年在医院治疗期间分离出的新兴病原体,特别关注耳鼻喉科。
在此期间,该医院共治疗了50586名儿童,进行了39386次细菌学检查,其中耳鼻喉科有6528名儿童(占12.9%),进行了1566次细菌学检查(占3.98%)。诊断按照常规微生物学程序进行,并对耐药性进行鉴定。
该医院治疗的2369名儿童(占4.68%)被确诊为新兴病原体感染,其中耳鼻喉科有84名儿童(占1.29%)。耳鼻喉科最常见的新兴病原体是化脓性链球菌、耐青霉素和对青霉素中度敏感的肺炎链球菌、耐甲氧西林金黄色葡萄球菌和轮状病毒。
耐青霉素和对青霉素中度敏感的肺炎链球菌以及轮状病毒感染是最常见的医院感染。系统的微生物学监测对于预防医院新兴病原体感染的传播必不可少。